Örhalmi J, Klos K, Ferko A, Jackanin S
Chirurgická klinika Lékařské fakulty UK v Hradci Králové a Fakultní nemocnice Hradec Králové.
Rozhl Chir. 2012 Dec;91(12):649-53.
Rectocele and intussusceptions are amongst the most frequent causes of Obstructed Defecation Syndrome (ODS). ODS diagnostics has been constantly improving which results in more precise indication criteria for individual surgical approaches. The work discusses indications for Stapled TransAnal Rectal Resection (STARR) as well as the results of the seven-year follow-up.
Female patients with ODS score over 7 were indicated for STARR procedure after all conservative treatment possibilities failed. The proper indication requires that other causes of ODS be excluded. The retrospective analysis of prospectively collected data was employed.
Between January 2005 and October 2012 29 STARR procedures for rectocele were performed. Morbidity rate of the set of our patients was 6.9%. None of the patients died. We recorded bleeding from the staple line in seven patients (without surgical revision), and urinary infection in two patients. Bleeding from staple line was present in seven causes and urinary infection was present twice.
The STARR procedure seems to be an effective and safe treatment for ODS associated with rectocele and intussusception. The overall morbidity rate is low. Further investigation is required to optimize patient's selection and to reduce the potential complications and failure during postoperative period.
直肠膨出和肠套叠是排便梗阻综合征（ODS）最常见的病因。ODS的诊断方法一直在不断改进，这使得个体手术方法的指征标准更加精确。本文探讨了吻合器经肛门直肠切除术（STARR）的指征以及七年随访结果。
所有保守治疗方法均失败后，ODS评分超过7分的女性患者被纳入STARR手术。正确的指征要求排除ODS的其他病因。采用对前瞻性收集的数据进行回顾性分析。
2005年1月至2012年10月期间，共进行了29例针对直肠膨出的STARR手术。我们这组患者的发病率为6.9%。无患者死亡。我们记录到7例患者吻合口出血（未进行手术修复），2例患者发生泌尿系统感染。吻合口出血出现7次，泌尿系统感染出现2次。
STARR手术似乎是治疗与直肠膨出和肠套叠相关的ODS的一种有效且安全的方法。总体发病率较低。需要进一步研究以优化患者选择，并减少术后潜在的并发症和失败情况。
